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Mang A, Jetelina KK, McNeely C, Durante JC, Sánchez V, Tiro JA, Francis JKR. Characteristics of parents who think intrauterine devices or contraceptive implants are "best" for their daughter: An exploratory analysis in Dallas, Texas. Contraception 2023; 125:110084. [PMID: 37263372 PMCID: PMC10527008 DOI: 10.1016/j.contraception.2023.110084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/16/2023] [Accepted: 05/24/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To explore characteristics of parents who prefer an intrauterine device (IUD) or implant compared to all other contraceptive methods. STUDY DESIGN Parents with an adolescent daughter completed a cross-sectional survey. The outcome evaluated the parent's perceived "best" contraceptive method for their daughter using bivariate statistics and multivariable modeling. RESULTS Of 115 parents, parental willingness to use IUD or implant themselves (p = 0.014) and thinking IUD or implant is best at preventing pregnancy (p = 0.001) remained positively associated with parents thinking IUD or implant is the "best" contraceptive method for their daughter. CONCLUSIONS Clinicians can consider integrating parents' personal experiences with IUD or implant during adolescent contraception counseling. IMPLICATIONS Caregivers' personal contraceptive knowledge and personal willingness to use LARC influences their preferences for their daughter's contraception. Clinicians can assess and integrate caregivers' perspectives during adolescent contraception counseling.
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Affiliation(s)
- Angela Mang
- School of Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States; University of Texas Health Science Center, School of Public Health, Dallas, TX, United States.
| | - Katelyn K Jetelina
- University of Texas Health Science Center, School of Public Health, Dallas, TX, United States; Meadows Mental Health Policy Institute, Dallas, TX, United States
| | - Courtney McNeely
- University of Texas Health Science Center, Houston, TX, United States
| | - Julia C Durante
- University of Texas Health Science Center, School of Public Health, Dallas, TX, United States; Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States; Children's Health, Dallas, TX, United States
| | - Victoria Sánchez
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Jasmin A Tiro
- Division of Biological Sciences, University of Chicago Pritzker School of Medicine, Chicago, IL, United States
| | - Jenny K R Francis
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States; Children's Health, Dallas, TX, United States
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Durante JC, Sims J, Jarin J, Gold MA, Messiah SE, Francis JKR. Long-Acting Reversible Contraception for Adolescents: A Review of Practices to Support Better Communication, Counseling, and Adherence. Adolesc Health Med Ther 2023; 14:97-114. [PMID: 37181329 PMCID: PMC10167958 DOI: 10.2147/ahmt.s374268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/12/2023] [Indexed: 05/16/2023] Open
Abstract
Long-acting reversible contraception (LARC) methods, including levonorgestrel and copper intrauterine devices (IUDs) and the subdermal contraceptive implant, are the most effective reversible forms of contraception and thus are an important aspect of adolescent pregnancy prevention. While LARC efficacy, safety, and appropriateness are supported by major medical organizations and usage rates are increasing, overall LARC uptake among United States (US) adolescents remains lower than uptake of short-acting contraceptive methods. A better understanding of the barriers affecting adolescent LARC uptake and reasons for discontinuation could help facilitate effective communication. For example, learning how to improve adolescent-centered communication, shared decision-making, and motivational counseling strategies may be the first step to improving utilization rates. This narrative review includes three sections. First, this review will describe the history, mechanisms of action, and epidemiology of adolescent LARC use in the US and globally. Next, this review will describe key factors influencing adolescent LARC uptake, reasons for discontinuation, and multilevel barriers specific to adolescent LARC use. Finally, this review will characterize communication techniques and LARC counseling strategies for adolescents in the context of a reproductive justice approach set in the health belief model framework. The distinction between moving away from a presumptive counseling approach towards an adolescent-centered, shared decision-making approach to encourage parent-adolescent sexual health communication to lay the foundation of empowering adolescent reproductive autonomy should be the underpinning of all effective reproductive communication strategies.
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Affiliation(s)
- Julia C Durante
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Children’s Health System of Texas, Dallas, TX, USA
| | - Jessica Sims
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Children’s Health System of Texas, Dallas, TX, USA
| | - Jason Jarin
- Children’s Health System of Texas, Dallas, TX, USA
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Melanie A Gold
- Department of Pediatrics and Department of Population & Family Health, Columbia University Irving Medical Center, New York, NY, USA
| | - Sarah E Messiah
- University of Texas Health Science Center at Houston, School of Public Health, Dallas Campus, Dallas, TX, USA
- Center for Pediatric and Population Health, UTHealth School of Public Health, Dallas, TX, USA
- Department of Pediatrics, McGovern Medical School, Houston, TX, USA
| | - Jenny K R Francis
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Children’s Health System of Texas, Dallas, TX, USA
- Peter O’Donnell School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Francis JKR, Weerakoon SM, Lucas SL, Mathew MS, Durante JC, Kelly N, Tiro JA. Human Papillomavirus Vaccination Before and During the COVID-19 Pandemic. JAMA Netw Open 2022; 5:e2234000. [PMID: 36121657 PMCID: PMC9486449 DOI: 10.1001/jamanetworkopen.2022.34000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This cross-sectional study compares human papillomavirus vaccinations by age and season before and during the COVID-19 pandemic.
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Affiliation(s)
- Jenny K. R. Francis
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas
- Children’s Health System of Texas, Dallas
| | - Sitara M. Weerakoon
- University of Texas Health Science Center School of Public Health, Dallas
- Center for Pediatric Population Health, Dallas, Texas
| | | | - Matthew S. Mathew
- University of Texas Health Science Center School of Public Health, Dallas
- Center for Pediatric Population Health, Dallas, Texas
| | - Julia C. Durante
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas
- Children’s Health System of Texas, Dallas
| | - Nancy Kelly
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas
- Children’s Health System of Texas, Dallas
| | - Jasmin A. Tiro
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas
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Abstract
The coronavirus disease 2019 pandemic has vastly disrupted the lives of youth. Stressors related to the pandemic and related lockdown measures have increased the prevalence of adolescent depression, suicidal ideation, and suicide attempts, with their mental and psychosocial development making them highly vulnerable to isolating restrictions. Research has demonstrated increased loneliness and decreased social support among adolescents during the pandemic. Increased social media usage has further affected depression among adolescents. Pandemic-related stressors such as fear of illness or life changes have negatively affected adolescent mental well-being. Health care use during the pandemic has involved disruption in primary care suicide screening, patterns of suicide-related presentations in emergency departments, and access to mental health services. Health care providers can support adolescent mental health through consistent screening, effectively coordinating referral for mental health evaluation, and providing family guidance on resiliency, pandemic-related mental health risks, and suicide prevention. [Pediatr Ann. 2022;51(4):e144-e149.].
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Durante JC, Woodhams EJ. Patient Education About the Affordable Care Act Contraceptive Coverage Requirement Increases Interest in Using Long-Acting Reversible Contraception. Womens Health Issues 2017; 27:152-157. [PMID: 28063850 DOI: 10.1016/j.whi.2016.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 11/23/2016] [Accepted: 11/29/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND The Patient Protection and Affordable Care Act (ACA) requires health insurance to cover all Food and Drug Administration-approved contraceptives at no cost to patients, including highly effective long-acting reversible contraception (LARC). Our objective was to determine whether a brief educational intervention about these provisions would increase interest in LARC use. METHODS This is a cross-sectional survey of women seeking contraceptive care in an urban outpatient obstetrics/gynecology clinic. We collected baseline contraceptive attitudes and knowledge of the ACA's contraceptive coverage provisions before the intervention. Our primary outcome was interest in using a LARC method before and after reading a short description of the ACA's contraceptive coverage provisions. RESULTS Surveys were completed by 316 participants. Most participants (52.8%) could not correctly identify any of the contraception coverage stipulations protected under the ACA. We observed a significant increase in LARC interest after the intervention in all participants (37.3% vs. 44.3%; p = .038), primarily among participants who did not originally identify any ACA provisions correctly (n = 167; 38.3% vs. 48.5%; p = .030). This subset also demonstrated a greater adjusted odds ratio of post-intervention LARC interest (odds ratio, 2.889; 95% CI, 1.234-6.723; p = .014). Interest in short-acting reversible contraception and contraception overall remained unchanged. CONCLUSIONS Most women seeking birth control lack comprehensive understanding of the contraceptive coverage protected by the ACA. Incorporating patient education about the ACA's no-cost contraception provision into routine contraceptive counseling may increase interest in LARC use and better enable women to make informed family planning decisions unrestrained by financial considerations.
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Affiliation(s)
- Julia C Durante
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
| | - Elisabeth J Woodhams
- Thomas Jefferson University, Department of Obstetrics and Gynecology, Philadelphia, Pennsylvania
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Kokona B, May CA, Cunningham NR, Richmond L, Jay Garcia F, Durante JC, Ulrich KM, Roberts CM, Link CD, Stafford WF, Laue TM, Fairman R. Studying polyglutamine aggregation in Caenorhabditis elegans using an analytical ultracentrifuge equipped with fluorescence detection. Protein Sci 2015; 25:605-17. [PMID: 26647351 DOI: 10.1002/pro.2854] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 12/01/2015] [Indexed: 11/11/2022]
Abstract
This work explores the heterogeneity of aggregation of polyglutamine fusion constructs in crude extracts of transgenic Caenorhabditis elegans animals. The work takes advantage of the recent technical advances in fluorescence detection for the analytical ultracentrifuge. Further, new sedimentation velocity methods, such as the multi-speed method for data capture and wide distribution analysis for data analysis, are applied to improve the resolution of the measures of heterogeneity over a wide range of sizes. The focus here is to test the ability to measure sedimentation of polyglutamine aggregates in complex mixtures as a prelude to future studies that will explore the effects of genetic manipulation and environment on aggregation and toxicity. Using sedimentation velocity methods, we can detect a wide range of aggregates, ranging from robust analysis of the monomer species through an intermediate and quite heterogeneous population of oligomeric species, and all the way up to detecting species that likely represent intact inclusion bodies based on comparison to an analysis of fluorescent puncta in living worms by confocal microscopy. Our results support the hypothesis that misfolding of expanded polyglutamine tracts into insoluble aggregates involves transitions through a number of stable intermediate structures, a model that accounts for how an aggregation pathway can lead to intermediates that can have varying toxic or protective attributes. An understanding of the details of intermediate and large-scale aggregation for polyglutamine sequences, as found in neurodegenerative diseases such as Huntington's Disease, will help to more precisely identify which aggregated species may be involved in toxicity and disease.
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Affiliation(s)
- Bashkim Kokona
- Department of Biology, Haverford College, Haverford, Pennsylvania, 19041
| | - Carrie A May
- Department of Molecular, Cellular and Biomedical Sciences, University of New Hampshire, Durham, New Hampshire, 03824
| | | | - Lynn Richmond
- Department of Biology, Haverford College, Haverford, Pennsylvania, 19041
| | - F Jay Garcia
- Department of Biology, Haverford College, Haverford, Pennsylvania, 19041
| | - Julia C Durante
- Department of Biology, Haverford College, Haverford, Pennsylvania, 19041
| | - Kathleen M Ulrich
- Department of Biology, Haverford College, Haverford, Pennsylvania, 19041
| | - Christine M Roberts
- Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, 80309
| | - Christopher D Link
- Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, 80309
| | - Walter F Stafford
- Boston Biomedical Research Institute, Watertown, Massachusetts, 02472
| | - Thomas M Laue
- Department of Molecular, Cellular and Biomedical Sciences, University of New Hampshire, Durham, New Hampshire, 03824
| | - Robert Fairman
- Department of Biology, Haverford College, Haverford, Pennsylvania, 19041
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